Prevention of parastomal hernias by prophylactic use of a specially designed intraperitoneal onlay mesh (Dynamesh IPST®)
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Hernias around ostomies are a very common complication, exceeding 50%. Only a few studies deal with the prophylactic use of mesh to prevent parastomal hernia revealing promising results.
Patients and methods
Twenty-two patients undergoing elective rectal surgery with a permanent colostomy—one with an ileostomy and two needing surgical correction of a preexisting colostomy—were enrolled in a prospective study. A specially designed mesh made of polyvinylidene fluoride with a central whole and a funnel arising (Dynamesh IPST®) was prophylactically implanted using an intraperitoneal onlay technique. The patients were followed for a median of 11 (range 2–19) months by clinical examination every 3 months.
No infection or any other adverse effect was observed, and no parastomal hernia or stoma protrusion could be detected clinically. Twelve patients had a routine computed tomography after 6 months, which also excluded any hernia formation.
The prophylactic use of Dynamesh IPST® is a safe and effective procedure preventing stoma complications such as hernia formation or prolapse, at least in the short run.
KeywordsParastomal hernia Prevention Mesh Postoperative complication Prospective observational study